What Is ADHD?
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), ADHD is characterized by inattentive type, hyperactive-impulsive type, or combined type. The symptoms of inattentive type ADHD include:
Careless mistakes when completing tasks Difficulty holding attention to non-preferred tasks Difficulty holding focus when spoken to directly Failure to finish tasks Disorganization Avoiding tasks that require a lot of effort Losing things Being easily distracted Forgetfulness
The symptoms of hyperactive-impulsive type ADHD include:
Fidgeting Getting out of one’s seat at inappropriate times Running or climbing at inappropriate times Inability to work or play quietly Moving as if “driven by a motor” Excessive talking Blurting answers before the question is finished Inability to wait one’s turn Interrupting in conversations
Symptoms typically manifest in early childhood, interfere with functioning, and are not attributed to another medical issue or mental health diagnosis. To be diagnosed with ADHD, you must have six or more symptoms of inattentive type ADHD, hyperactive-impulsive type ADHD, or both.
Why Would Someone Get Tested for ADHD as an Adult?
People with ADHD are born with brain differences from those who do not have ADHD. However, these symptoms might not manifest until later in life. This can occur when people with ADHD mask their symptoms due to protective influences such as parental organization or high IQ, or there is a misdiagnosis with another condition such as anxiety. When someone masks their ADHD symptoms, they may go undiagnosed until adulthood. Neurodevelopmental differences often manifest in childhood, but if a person is able to compensate for their symptoms, they might not display symptoms until they are older. For many people, the COVID-19 pandemic led to increased stress levels that interfered with their ability to compensate for attention issues or executive dysfunction. Additionally, working from home created the added challenge of living at work and having more freedom over the structure of the day. Many adults reported increased stress, more difficulty with decision making, and more mental health issues than before the pandemic, leading to an increase in seeking services and evaluations.
Since many think of ADHD as a childhood diagnosis, it can be challenging to get diagnosed as an adult. Adults might attribute their symptoms to depression, not realizing that they have ADHD. However, tests and assessments for adults with undiagnosed ADHD are available.
What Adult ADHD Tests Exist?
Getting diagnosed with ADHD as an adult can be challenging because symptoms look different in children when compared to adults, and many specialists primarily diagnose children. For example, adults might not manifest as many hyperactive symptoms as children or might experience hyperactivity in the form of racing thoughts rather than body movements. There are several measures that providers can use to assess adults for ADHD:
Test of Variable Attention (TOVA): The TOVA measures your ability to attend to a non-preferred task and assesses your attention skills in real time. It compares your performance to others who do and do not have ADHD. Sometimes the TOVA is inconclusive, or someone with an attention issue can perform well because they are compensating, and so the TOVA is usually not given by itself. Conners Adult ADHD Rating Scales (CAARS): The CAARS is a rating scale that measures attention, impulse control, and hyperactivity. It determines whether your symptoms are consistent with ADHD. There is a self-report scale and an observer scale, which someone who knows you well can complete. Adult ADHD Self-Report Scale (ASRS): The ASRS is another self-report measure that determines how closely your symptoms match the DSM diagnostic criteria for ADHD. The Behavior Rating Inventory of Executive Functioning-Adult Version (BRIEF-A): The BRIEF-A looks at various aspects of executive functioning, such as your ability to follow through on tasks, shift between activities, organize belongings or thoughts, and recall important information. It compares any difficulties you are having to others your age to determine if deficits are present. Barkley Adult ADHD Rating Scales (BAARS): The BAARS is similar to the CAARS and uses both self-report and observer data to measure your symptoms compared ot the DSM diagnostic criteria for ADHD. Cognitive Assessments: Although your cognitive abilities alone do not determine whether or not you have ADHD, they can help in determining what your strengths and weaknesses are and help with treatment planning.
Who Can Diagnose ADHD in Adults?
It can be overwhelming to find a provider to evaluate you for ADHD. Your primary care provider or insurance company might be able to provide you with referral information for an evaluation. If you have an individual therapist, they might have referral options as well. Many psychologists have training in psychological evaluations. Additionally, some psychiatrists are able to assess for and diagnose ADHD. If there is a graduate psychology program or medical school in your area, they might offer assessments. You can search therapist directories for providers who specialize in ADHD assessment and treatment.
What Happens After You Are Diagnosed?
If you meet criteria and are diagnosed with ADHD, your provider should provide you with treatment options and recommendations. Many organizations offer free resources and education about ADHD that can help you understand your symptoms and put you in touch with sources of support. These resources can also help your loved ones understand your diagnosis. Depending on your needs and preferences, you might benefit from therapy services to help you manage your symptoms or treat any other diagnoses you might have in addition to ADHD. Your provider might also recommend medication to manage your symptoms. You can ask questions and determine what treatment options are right for you.
